Early this morning we watched as Congress passed a sweeping spending agreement and sent the package to the White House for the President's signature. Along with a two-year agreement on spending, the package accomplished four of the College's top policy priorities: • Fixed the CMS rule that would have applied payment adjustments to Part B drug reimbursements and penalized physicians for providing high-cost drugs;
• Permanently repealed the arbitrary Medicare therapy caps, which could have affected millions of patients' access to vital rehabilitation services;
• Repealed the Independent Payment Advisory Board (IPAB), which would have had the power to impose cuts on providers without the review and deliberation of the regular legislative process; and• Eliminated the Medicare Part D "donut hole," supporting our patients' ability to adhere to treatment plans.
These are incredible victories for the Rheumatology, arthritis, and general medical communities that come after months of sustained advocacy efforts of the ACR and the participation of countless ACR/ARHP members. In particular, the rheumatology community led the charge to stop Medicare payment adjustments on Part B drugs. To those of you who contacted congressional offices, submitted letters to the editor to your local paper, and gave money to RheumPAC - your efforts paid off today. Because of your investment of time, talent, and money to magnify the College's voice on Capitol Hill, Congress heard us loud and clear. Thank you!

Even as we celebrate these victories, there is still much work to do to ensure that the 54 million Americans living with RA and other rheumatologic conditions can continue to access innovative, medically necessary, and life-sustaining care. Stay tuned as we continue to advance policies that provide relief from administrative hassles, boost rheumatology research and training, minimize our workforce shortage, and reduce drug costs so that patients can access innovative, critical treatments.

To address the challenges that lie ahead, it will take all of us pulling together to protect our patients and our profession. Thank you to all members of the ACR and ARHP who regularly take action on behalf of our patients. Thank you also to those members who are contributors to RheumPAC. Investing in RheumPAC is critical to help the ACR build the relationships with Congress that lead to these victories.

The ACR will continue to work for you, so you can be there for your patients.

This will be a huge help in preserving the needed access to care for patients with rheumatic diseases, especially those requiring some very costly drugs and other prescriptions to maintain a high quality of life and well controlled arthritic conditions and joint protection.

Good to see much needed help and cooperation from the Congress, Senate , and President.
Mark Fisher MD

Reuters reports that the incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients.

Researchers analyzed Medicare claims data from 2002 to 2015, from more than 2 million women age 65 or older. They found that hip fracture rates declined each year from 2002 to 2012, the researchers found. But starting in 2013, hip fracture rates leveled off and were higher than expected.

Increases in fracture rates were prominent in women ages 65 to 69, which had risen by 2.5 percent, and in women ages 70 to 74, which had risen by 3.8 percent, from 2014 through 2015.

The net results is more than 11,000 additional estimated hip fractures over the time periods 2013 to 2015.

The U.S. Preventive Services Task Force (USPSTF) recommends that women age 65 or older get screened for osteoporosis with a type of X-ray called a DEXA scan to measure bone loss. Postmenopausal women under age 65, with risk factors for osteoporosis, should also be screened. Risk factors include a family history of osteoporosis, diseases such as rheumatoid arthritis, the use of certain medications, and smoking and drinking alcohol.

Osteoporosis screening by DEXA or bone density exams is critical since there is a 25% mortality risk over 1 year and 25% risk of functional limitation after hip fractures. This is a TREATABLE DISEASE and prevention is key!!

This past weekend I was fortunate to lecture at the Harvard Advances in Rheumatology Course, where I reviewed the safety issues surrounding the use of biologic therapies. In discussing infections, cancer, cardiovascular events, etc., it became very clear to me that these problems, while worrisome, are often escalated in their importance – all at the expense of what is most dangerous: RA itself."

I do agree with this blog from Dr. Kush. We must alway keep the proper and correct perspective

when we evaluate our conditions and make decisions on accepting and seeking treatment. There are always

potential risks with treatments of diseases AND ALSO NOT treating diseases!

We must remember this and keep the proper balance and appropriate judgements in optimizing our health care and wellness.

Find out more about this inflammatory autoimmune disease and how to treat it.

Have you or a loved one recently been diagnosed with rheumatoid arthritis? If so, then chances are good that you are looking for more information about this condition and the treatment options available to you to reduce your painful symptoms, reduced your risks for joint damage, and preserve your overall functioning. Our Haddon Heights, NJ, Rheumatologist, Dr. Mark Fisher, is here to answer all of your questions about rheumatoid arthritis so you can understand more about this chronic condition and what you can do about it.

What is rheumatoid arthritis (RA)?

This chronic condition is an autoimmune disorder that attacks the joints of the body. This can lead to a thickening of the tissue around the joint known as synovitis. This thickening leads to widespread pain and swelling and potential damage to the joints. Joint deformity and malfunction can result and a disabling, progressive arthritis affecting multiple joints in a symmetrical fashion ensues.

If RA is left untreated, it can cause permanent damage to the joints, tissue and cartilage, which is why it’s so important to visit our Haddon Heights rheumatoid arthritis doctor right away for an early diagnosis. The sooner we can start treatment the better. Early diagnosis and management is always the key to the best success!!

What are the symptoms?

Those with RA will experience a variety of different joint-related symptoms including,

Swelling, stiffness and joint pain (lasting longer than six weeks).

Prolonged morning stiffness more than 1-3 hours distinguishes RA from the usual arthritis we may experience with age known as osteoarthritis.

Widespread joint discomfort, usually in a symmetrical distribution

Pain and swelling within smaller joints

(e.g. joints within the hands or feet) and also can include larger joints ( e.g. shoulders, hips, and knees)

Along with joint pain, swelling, and inflammation, those with RA may also have a lack of an appetite, weight loss, chronic lethargy, fever, lumps or nodules over the elbows and other areas. RA symptoms may flare-up and is characterized by such exacerbations of pain and swelling of joints, and can last several months; however, this also means that there are periods of lesser activity of symptoms where you might experience fewer symptoms.

Since RA is an autoimmune disorder it can affect everything from the eyes and skin to the lungs and even the blood.Patients with such a disorder can also have higher risks for internal problems such as cancer, cardiovascular complications, anemia, and other medical problems.

How is RA treated?

While RA cannot be cured, but there is a very effective treatment for it. The inflammation and pain can be managed and complications (e.g. joint damage and other risks) can be greatly reduced through early diagnosis and with the proper medication. Common RA medications include,

Biologic monoclonal antibodies and these have made phenomenal changes in the course of this illness for many and life-changing impact on patients' lives and functionality

During your visit, we will discuss which medications will help your symptoms and offer the best overall plan to maintain your function and joint protection with the least risks.

If you are looking for a Rheumatologist in Haddon Heights, NJ, who can help your RA symptoms and to improve your quality of life, then look no further than our very own Dr. Fisher. Our compassionate, caring team is here to help you every step of the way, so you can enjoy what really matters in life.

While arthritis is a common diagnosis and ailment for many, the word alone does not always tell the whole story. It is actually a very inclusive and encompassing term for many types of arthritis and related conditions. Recognizing the signs of arthritis early can help assist in effectively diagnose, treat, and manage these conditions. Find out more about the symptoms and signs and possible complications of arthritis and what your doctor can do to treat it with Dr. Mark Fisher in Haddon Heights, NJ.

What are the symptoms of arthritis?
Arthritis affects the joints and often increases in severity with age. Two major types of arthritis are osteoarthritis, occurring with wear and tear with age or injury, and the inflammatory type such as rheumatoid arthritis, an immune related condition that affects the body symmetrically involving the small and large joints, such as both wrists, hands, elbows, hips, or both knees and ankles. The early symptoms of arthritis include early morning stiffness and pain, and may include joint swelling and these symptoms may depend on the type of arthritis you have.

Diagnosing Arthritis
Your doctor will use the medical history and physical examination and certain laboratory and X-ray studies and careful consideration of this information to diagnose your arthritis-related condition. Often, all of this information can help diagnose the more specific classification of the arthritis related condition you may have. Doctors can also test a joint fluid sample to search for evidence of infectious arthritis or gout in some cases. The collection of symptoms, physical findings, lab and X-ray results can assist the arthritis specialist or Rheumatologist prepare the likely diagnosis and suggest the appropriate management plan to protect the joints and improve and reduce activity of the arthritic or autoimmune process.

Arthritis Treatments in Haddon Heights, NJ
Many of the initial treatments for arthritis may include rest, increased exercise, physical therapy, or occupational therapy. If these methods do not provide adequate results, over-the-counter or prescription drugs may help manage the symptoms. The type of medication will depend on the underlying arthritis condition causing your symptoms. These drugs may include disease-modifying anti-rheumatic drugs (DMARDs) or Biologic response modifiers. These may help prevent the condition from worsening and preserve the joint’s functionality and range of motion and overall health of the patient. Your doctor may suggest surgery in severe cases, such as joint replacement, but these treatments can substantially reduce the need for surgery or risks of disability.

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